Abstract
BackgroundWe assessed the impact of parental history of stroke on stroke mortality, as well as the effect modification between lifestyle and stroke mortality, among Japanese.MethodsIn this community-based, prospective cohort study, 22 763 men and 30 928 women aged 40 to 79 years with no history of cardiovascular disease or cancer at baseline (1988–1990) were followed through 2008. We examined the association between parental history of stroke and stroke mortality and estimated the impact of the combination of lifestyle and parental history on stroke mortality in offspring.ResultsDuring a mean follow-up period of 15.9 years, there were 1502 stroke deaths. In both sexes, participants with a parental history of stroke had a higher risk of stroke mortality as compared with those without such a history. The respective multivariable hazard ratio (95% CI) and population attributable fraction were 1.28 (1.10–1.49) and 5.4% in men, 1.22 (1.04–1.43) and 4.3% in women, and 1.25 (1.12–1.40) and 4.8% in all participants, for offspring with a maternal and/or paternal history of stroke. There was an inverse association between healthy-lifestyle score and stroke mortality, irrespective of parental history of stroke. The overall multivariable hazard ratio for the highest (6–8) versus the lowest (0–3) score categories was 0.56 (95% CI, 0.43–0.72) for participants with a maternal and/or paternal history of stroke and 0.44 (0.36–0.53) for those without such a history.ConclusionsParental history of stroke was associated with stroke mortality in offspring. The inverse association between healthy lifestyle behaviors and stroke mortality, regardless of parental history, suggests that lifestyle modification is beneficial, even among individuals with a parental history of stroke.
Highlights
Prospective cohort study of samples of Japanese men and women from the general population, we examined the association of parental history of stroke with stroke-related mortality risk in their offspring and determined whether the association between lifestyle behaviors and stroke mortality was modified by parental history
We found that the inverse relationship observed between healthy lifestyle behaviors and mortality was similar in both men and women and stronger in younger than in older adults, regardless of parental history of stroke, with the exception of paternal stroke history and stroke mortality in women
In conclusion, a parental history of stroke was associated with an increased risk of stroke mortality among a Japanese population
Summary
There is substantial evidence of a relationship between a family history of coronary heart disease in parents and increased risk of coronary heart disease in their offspring.[1,2] the evidence of such an association with stroke is limited, and the results of studies have been inconsistent.[3,4,5] Current guidelines for assessment of cardiovascular risk[6] recommend consideration of a parental history of early-onset cardiovascular disease (onset age
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